Interceptive Orthodontics

At my 6 1/2 year-old daughter's first dentist visit we became aware of the bite which is off to the side. We consulted with a pediatric specialist who recommended she get an appliance to enlarge her top arch. Is this done at such a young age?

Question:

Yes, appliances can be placed at an early age (as early as 6 or 7 years old). This early treatment is sometimes referred to as "interceptive orthodontics". If it is determined there is a spacing problem or cross-bite problem (where the lower teeth overlap the upper teeth instead of the "normal" overlap of uppers over lowers) due to inadequate growth of the dental arches, the growth of the child can be utilized to create more space or to correct cross-bites. With early intervention, extraction of permanent teeth to increase space is less likely, and the final results are more stable than waiting until growth is nearly complete when all the permanent teeth have erupted.

At 6-7 years old, your daughter is probably in what we call the "mixed dentition stage", where both primary teeth and permanent teeth are present. If only the primary teeth are in crossbite and the chewing surfaces are in contact, little may be gained from early treatment, as the crossbite may or may not occur in the permanent teeth. If the crossbite is present in the permanent molar and no other evidence of crossbite exists, molar position should be corrected. This may be the only treatment needed.

Prior to commencing orthodontic treatment for this condition, however, you should confirm whether this is a true crossbite or one created by an occlusal interference. An occlusal interference would be a premature touching of an upper and lower tooth which might cause the jaw to move to one side. "Unilateral crossbites" can be caused by this deflection.

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